Do I need to ask my doctor’s permission to stop anticoagulants in patients with nephrotic syndrome combined with deep vein thrombosis?

  Nephrotic syndrome is a common clinical manifestation of glomerular disease, accounting for about 45% of inpatients with kidney disease at BYUH. These patients often have a hypercoagulable state and are prone to combined deep vein thrombosis, such as in the lower extremities. If combined with deep vein thrombosis, anticoagulation is often required for at least six months to prevent the progression of the thrombosis from worsening. Some patients sometimes discontinue anticoagulants on their own because they are concerned about the risk of bleeding from anticoagulants or because they do not understand the implications of anticoagulant therapy. Recently, a young male patient with nephrotic syndrome, inferior vena cava thrombosis and deep vein thrombosis came to Beijing from overseas for further consultation and treatment, as discussed in the nephrology ward of Peking University Hospital. Prior to hospitalization, he stopped anticoagulants on his own for more than ten days, and the thrombosis had progressed after hospitalization. This patient was at high risk of discontinuing anticoagulants; therefore, experts warned that discontinuation of anticoagulants in patients with deep vein thrombosis requires physician consent.